Altered Reward Processing in Obsessive-Compulsive Disorder: Insights From Active and Observational Learning.

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Obsessive-compulsive disorder (OCD) is linked to altered performance monitoring, evidenced by enhanced error-related negativity.
• Overactive error processing is also observed in anxiety disorders, suggesting shared neural mechanisms.
• It remains unclear if feedback processing, specifically the feedback-related negativity (FRN), is altered in OCD or differs between self-performed and observed outcomes.

Purpose of the Study:

• To investigate feedback processing and performance monitoring in OCD patients compared to healthy controls (HCs) and social anxiety disorder (SAD) patients.
• To examine differences in learning from self-performed versus observed outcomes in OCD.
• To explore potential shared mechanisms between OCD and SAD.

Main Methods:

• Compared electroencephalography (EEG) data from 27 OCD patients, 27 HCs, and 29 SAD patients during an active and observational probabilistic feedback learning task.
• Analyzed event-related potentials, focusing on the feedback-related negativity (FRN).

Main Results:

• OCD patients demonstrated impaired task performance and more indecisive behavior compared to HCs across both learning conditions.
• OCD patients showed generally more positive FRN amplitudes, with enhanced valence coding for wins, particularly in active learning.
• No significant differences in FRN responses to losses were observed between groups.

Conclusions:

• OCD is associated with deficient reward processing rather than punishment processing.
• Similar performance monitoring alterations in OCD and SAD suggest the involvement of general, disorder-shared mechanisms.
• Intolerance of uncertainty, pessimism, and depressiveness are discussed as potential underlying mechanisms.